Chest Wall Injury

HISTORY:

Chest wall injury sustained ‍ ‍days ago

Event: ‍ ‍unclearfalldirect blowrepetitive motionliftingoveruse

Location:: ‍left chestright chest

Radiation: ‍none

Severity: ‍mildmoderatesevere, ‍012345678910 / 10

Type: ‍dullaching

Pattern: ‍constantintermittent

Worsening factors: ‍none

‍shortness of breath

‍cough

‍palpitations

‍dizziness

‍syncope

Treatments tried: ‍none, ‍effectiveineffective

Occupation: ‍



EXAM:

General appearance: ‍well-appearing

Vital signs: ‍normal, BP ‍, HR ‍, RR ‍, SpO2 ‍ %, Temp ‍°

Neck: ‍normallymphadenopathy

Heart: ‍RRR, ‍normal S1 and S2

Lungs: ‍clearabnormal sounds, ‍retractions

Chest: ‍tenderness on ‍rightleft ‍

Breasts: -R: ‍normal, -L: ‍normal

Abdomen: ‍softsemi-softtense, ‍non-tender ‍, ‍non-distended, ‍

Skin: ‍no rash

Extremities: ‍edema, ‍warm, cap refill ‍< 3 sec> 3 sec, pulses ‍normal, ‍



ASSESSMENT:

‍Chest wall contusion ‍likelysuspectedpossible

DDx: ‍



PLAN:

- Chest X-ray

- ECG

- Troponin

- ‍Acetaminophen

- ‍NSAIDs

- ‍Opioids

- Activity as tolerated

- Respiratory exercises

- Referral to ER

- Follow-up in ‍ ‍daysweeks

- Return if symptoms worsen or if new symptoms develop such as shortness of breath